1144201773 NPI number — JOHNS HOPKINS UNIVERSITY

Table of content: (NPI 1144201773)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144201773 NPI number — JOHNS HOPKINS UNIVERSITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOHNS HOPKINS UNIVERSITY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
JHU - ANESTHESIA/CRNA'S
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144201773
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 64382
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21264-4382
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 N WOLFE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21205-2101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-550-8432
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
KEATING
Authorized Official First Name:
SHAVONDA
Authorized Official Middle Name:
L
Authorized Official Title or Position:
SR PRODUCTION UNIT MGR
Authorized Official Telephone Number:
410-933-6430

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CA9045 . This is a "RRMC" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 219705700 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 056342200 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".




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